Despite advances in anti-emetic therapy, chemotherapy-induced nausea and
vomiting (CINV) still poses a significant burden to patients undergoing
chemotherapy. Nausea, in particular, is still highly prevalent in this
population. Ginger has been traditionally used as a remedy for gastrointestinal
complaints and has been suggested as a viable adjuvant treatment for nausea and
vomiting in the cancer context.

Aim:

To inform clinicians of the relevant literature regarding gingers
application as an anti-CINV agent.

Methods:

Data generated from three recent systematic reviews regarding the
clinical efficacy, mechanisms of action, and safety concerns of ginger in the chemotherapy
setting will be presented.

Results:

Bioactive compounds within the rhizome of ginger interact with several
pathways that are directly implicated in CINV (i.e. 5-HT3 antagonism) in
addition to pathways that could play secondary roles by exacerbating symptoms.
In regards to gingers clinical efficacy, of the seven RCTs included in our
review, five reported favourable results. Of these, three studies found ginger
reduced either acute nausea only or both acute and delayed nausea and vomiting
when combined with standard anti-CINV treatment. The two remaining studies
found ginger reduced either acute or delayed nausea and vomiting equal to
metoclopramide. An oft-cited concern of ginger usage is its potentially adverse
effects on platelet aggregation; however, our review was unable to find
consistent data to support this conclusion.

Conclusions:

While there have been multiple viable mechanisms of action identified as
well as several clinical studies that support the use of ginger for CINV, the
considerable limitations in the methodology employed in some studies present
genuine uncertainty about its efficacy in the chemotherapy setting and further
trials are currently being conducted to resolve these uncertainties.
Furthermore, while the concerns regarding ginger’s interaction with
anti-coagulant therapy are not firmly supported by the current literature,
caution is advised in at-risk patients.